Bidirectional barbed polydioxanone filament insertion in vastus medialis oblique muscle for knee osteoarthritis improvement

Abstract

Background: Strengthening the quadriceps muscle in patients with knee osteoarthritis (OA) can effectively alleviate symptoms such as pain and swelling. However, the use of bidirectional barbed polydioxanone filament (BBPF) for this purpose remains underexplored. Therefore, this study aimed to evaluate the impact of a new muscle enhancement and support therapy (MEST) involving the insertion of a BBPF into the vastus medialis obliquus (VMO) to improve the symptoms of knee OA.

Methods: In a multicenter, randomized, double-blind study, we evaluated 131 patients over 40 with Kellgren-Lawrence grade II-III medial compartment knee OA. Of these, 88 received BBPF insertion into the VMO (MEST group), and 43 were in the control group. We compared pain levels (via a visual analog scale (VAS) during weight-bearing and walking), quadriceps muscle strength (IMCSQ), Patient Global Impression of Change (PGIC), and Clinical Global Impression of Change (CGIC), assessing outcomes before and after the procedure.

Results: At four and eight weeks post-procedure, the VAS scores during weight-bearing and walking were significantly lower in the MEST group compared to the control group (P = 0.001). The differences in the IMCSQ at four and eight weeks post-procedure were significantly higher in the MEST group (P = 0.001). The PGIC and CGIC scores improved significantly at four weeks post-procedure (P = 0.001).

Conclusion: By reducing pain, improving function, and increasing muscle strength, MEST shows promise as a valuable addition to current treatment options. The biodegradable nature of the sutures suggests that repeat procedures may be beneficial, warranting further investigation to optimize this technique for wider clinical use.